Bouwman, R., Friele, R., Bomhoff, M.
How should the Inspectorate act according to the public?
Context: In the wake of various high-profile incidents in a number of countries, regulators of healthcare quality have been criticised for their ‘soft' approach. Also, concerns were expressed about public confidence. Differences seem to exist between what the public expects from a regulator of healthcare and the values as expressed in underpinning policy and legislation. However, for The Netherlands, it is unclear whether this difference really exists or whether the apparent difference is only a result of media interest. Methods: A questionnaire was submitted to 1500 respondents of the Dutch Healthcare Consumer Panel. Questions were developed around central ideas underlying healthcare quality regulation policies. The response rate was 58.3%.
Results: The public sees the regulator as the most important party for quality of care. In the public opinion care providers come after the regulator. Patients rated themselves as having the least responsibility. We noticed similar patterns for the food service industry and the education sector.
The public sees complaints about health care from patients' associations as an important source of information for quality regulation, while fewer respondents trusted information delivered by care providers. Finally: respondents supported the regulator's softer approach. When a care institution delivers poor care the Inspectorate should, according to the vast majority of people, double check the care situation and provide recommendations for improvement. Discussion: Result show that gaps and similarities exist between public expectations of regulation and the underpinning policies and legislation. There is little confidence in the regulator's use of information obtained from care providers' internal monitoring, while a larger role is seen for complaints of patient organisations.
From the perspective of both the Inspectorate and care providers it, however, is inconceivable, that an Inspectorate would not, also, rely upon the information that is collected by care providers themselves. It would not only be inefficient, but using this information also provides the inspectorate with information on the degree of control by care providers. The public seems to agree with the values in legislation and policy regarding the regulator's approach. A gradual, and often soft approach, is favoured by the public in spite of the criticism that is voiced in the media regarding this approach.